October 31, 2017

An Analysis on Scaling Digital Health in Developing Markets

GSMA Intelligence, in collaboration with the GSMA mHealth programme, has published its latest research on the digital healthcare landscape in developing countries. The report, Scaling Digital Health in Developing Markets: Opportunities and recommendations for mobile operators and other stakeholders, explains that "digital health is taking its first steps in some African, Asian and Latin American countries. The number of initiatives is growing, with a widespread opinion that digital health can help address key healthcare issues if it reaches scale." Furthermore, "This report provides an overview of the healthcare landscape in developing countries and assesses the role of digital health to help address key issues. It looks at technology enablers, challenges, use cases and evidence of the positive impact digital health can have on key health indicators. The report also assesses the role and opportunity for mobile operators and what needs to be done to scale digital health."

The report's Executive Summary presents the following four points:

1. Healthcare landscape – poor coverage and quality, and low digitization are key issues. "Developing countries continue to face poor healthcare funding, which affects access, quality, cost and key health outcomes," notes the report. In addition, "The healthcare sector is a late-comer to digitization, even in high-income countries. Implementation is phased over a period of decades. Priorities among low- and middle-income countries at an earlier stage of development are focused on addressing fundamental access and quality issues as well as cost inefficiencies. Advanced regions (US, Europe, parts of Asia) are exploring the use of artificial intelligence, Internet of Things, automation, cloud computing and big data for enhanced healthcare delivery and cost reduction."

2. Widescale digital health can help address key healthcare issues. "Early digital health solutions in some developing countries show encouraging results but greater scale is needed to drive longer-term benefits. Digital health needs to focus on three objectives over the next five to ten years – help to expand coverage (access), enhance services (quality) and optimize resources (cost). Some solutions can help achieve multiple objectives."

3. Scaling digital health – what needs to be done? "Digital health is still in its infancy. Many pilots are not followed by full-scale implementation due to a lack of sustainable financing, high risks for individual stakeholders and long time-to-market for commercial solutions."

The report further explains:
Greater and more stable government investment in digital health – as opposed to cyclical/individual initiatives – can help drive scale in developing countries, as venture-capital activity is limited and private sector healthcare provision is at a low scale. Digital health stakeholders need to stimulate government investment by demonstrating how digital health solutions help address national healthcare issues of poor access, quality and cost inefficiencies. Ministries of health also need to encourage and support the implementation of national digital health plans aligned with ICT and broadband agendas. Policy and regulations that promote investment and facilitate faster time-to-market of digital health solutions are a further enabler to adoption and scale.
Governments spend about $1 trillion per year on health in developing countries. If local governments allocate 0.5% of that to digital health initiatives over the next five years, a cumulative $25 billion will be available for digital health companies, including operators.
Ecosystem collaboration is needed to address current fragmentation and create a holistic digital health model. Individual companies do not own the full set of resources and capabilities required. Public-private partnerships (PPPs) serve to share resources, capabilities, opportunities and risks among stakeholders. Such collaboration brings the potential for greater social and economic value for all stakeholders in the ecosystem. In a holistic digital health platform model, new core and complementary services can be more easily integrated and packaged for B2B clients.
Industry collaboration is also needed to address current interoperability issues and drive healthcare data integration. EHRs, for example, need to include a complete and secure patient data history that can be shared in realtime across healthcare organisations. Data integration also improves healthcare worker and patient trust in the health system, and increases the overall value of data collected, dramatically increasing the potential for AI and other advanced technologies in the longer term. The mobile industry can help by advising on the application of standards and by working with healthcare industry partners to deliver services based on the principle of interoperability.
4. Mobile operators need to pursue a holistic approach to digital health and position as ICT and digital service partners. Encouragingly, "Mobile operators are engaged in digital health in developing countries. All the largest groups – Vodafone, Bharti Airtel, Telef√≥nica, America Movil, Telenor, Orange, MTN – as well as a number of smaller operators provide a range of B2G, B2B and B2C services."

In addition, "The current size of digital health across developing countries is small but the factors discussed earlier can drive scale. For operators, health is a nascent revenue stream and a further platform for cross-sector partnerships. Digital health usually sits within a wider 'Business Services' unit. This allows a holistic approach to societal digitization and helps navigate the IoT learning curve."

"To be relevant in the digital health space," however, "operators need to adopt strategies that can strengthen their role as ICT and digital service partners for governments, health providers and health tech companies. A holistic approach that looks at digital health as an integrated – as opposed to fragmented – portfolio of services is crucial to drive partnerships and opportunities, both locally and regionally.

For those who work in the digital health sector in developing countries, I recommend reading the GSMA report. Do you agree with the report's findings?

Aaron Rose is an advisor to talented entrepreneurs and co-founder of great companies. He also serves as the editor of Solutions for a Sustainable World.

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